| |
14235 Table Rock Rd Central Point OR 97502-9377 | |
(541) 494-6818 | |
(541) 494-6816 |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 14235 Table Rock Rd, Central Point, Oregon |
Authorized Official Name and Position | Tara Lynette Jeannot (CHIEF OPERATIONS OFFICER) |
Authorized Official Contact | 5415356239 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
931 Chevy Way Medford OR 97504-4127 Ph: (541) 535-6239 | 14235 Table Rock Rd Central Point OR 97502-9377 Ph: (541) 494-6818 |
NPI Number | 1821572884 |
---|---|
Provider Enumeration Date | 09/17/2018 |
Last Update Date | 07/15/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821572884 | NPI | - | NPPES |
022868 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
La Clinica Del Valle Family Health Care Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 S 2nd St, Central Point, OR 97502 Phone: 541-535-6239 | |
Providence Health & Services - Oregon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 S Front St, Suite 200, Central Point, OR 97502 Phone: 541-732-8000 Fax: 541-732-3404 | |